Post operative ambulatory exercises

POST OP AMBULATORY EXERCISE

1. Post operative ambulatory exercises Presented by Monika Devi Msc(N) HCN, SRHU

2. Post –operative exercises Regular exercise to restore the knee mobility, strength and a gradual return to everyday activities are important for the full recovery of post operative patients. orthopaedic surgeon and physical therapist may recommend that exercise approximately 20 to 30 minutes two or three times a day and walk 30 minutes, two or three times a day during early recovery.

3. Post –operative exercises orthopaedic surgeon may suggest some of the following exercises. The following guide can help the patient to better understand their exercise/activity program, supervised by therapist and orthopaedic surgeon the health care provider.

4. Early postoperative exercises Start these exercises as soon as the patient is able . Patient can begin these in the recovery room shortly after surgery . patient may feel uncomfortable at first, but these exercises will speed the recovery and actually diminish your postoperative pain .

5. Early postoperative exercises 1. Quadriceps Sets Tighten the thigh muscle. Try to straighten the knee. Hold for 5 to 10 seconds. Repeat this exercise approximately 10 times during a two minute period, rest one minute and repeat. Continue until the thigh feels fatigued

6. Straight Leg Raises Tighten the thigh muscle with your knee fully straightened on the bed, as with the Quad set. Lift the leg several inches. Hold for five to 10 seconds. Slowly lower . Repeat until your thigh feels fatigued. Patient also can do leg raises while sitting . .

7. Ankle pumps Move the foot up and down rhythmically by contracting the calf and shin muscles. Perform this exercise periodically for two to three minutes, two or three times an hour in the recovery room . Continue this exercise until you are fully recovered and all ankle and lower-leg swelling has subsided.

8. Knee straightening exercises Place a small rolled towel just above the heel so that it is not touching the bed . Tighten your thigh. Try to fully straighten the knee and to touch the back of your knee to the bed. Hold fully straightened for five to 10 seconds. Repeat until your thigh feels fatigued.

9. Bed supported knee bends Bend the knee as much as possible while sliding the foot on the bed. Hold the knee in a maximally bent position for 5 to 10 seconds and then straighten. Repeat several times until the leg feels fatigued

10. Sitting supported knee bends While sitting at bedside or in a chair with the thigh supported, place the foot behind the heel of the operated knee for support. Slowly bend the knee as far as patient can . Hold the knee in this position for 5 to 10 seconds. Repeat several times until the leg feels fatigued or until patient can completely bend the knee. Sitting Unsupported Knee Bends

11. Early activity Soon after surgery, patient will begin to walk short distances in the hospital room and perform everyday activities. This early activity aids the recovery and helps the patient’s knee regain its strength and movement. Proper walking is the best way to help knee recover . At first, patient will walk with a walker or crutches .

12. Early ativity Stand comfortably and erect with your weight evenly balanced on the walker or crutches . Advance the walker or crutches a short distance; then reach forward with the operated leg with the knee straightened so the heel of the foot touches the floor first .

13. Early activity As the patient move forward, the knee and ankle will bend and the entire foot will rest evenly on the floor. As the patient complete the step, the toe will lift off the floor and the knee and hip will bend so that the patient can reach forward for the next step . Remember, touch the heel first, then flatten the foot , then lift the toes off the floor.

14. Early activity Walk as rhythmically and smooth as they can . Don't hurry . Adjust the length of step and speed as necessary to walk with an even pattern . As muscle strength and endurance improve, patient may spend more time walking .

15. Early activity patient will gradually put more weight on the leg. You may use a cane in the hand opposite your surgery and eventually walk without an aid.

16. Stair climbing and descending The ability to go up and down stairs requires strength and flexibility . At first, the patient will need a handrail for support and will be able to go only one step at a time . Always lead up the stairs with good knee and down the stairs with operated knee . .

17. Stair climbing and descending Remember, "up with the good" and "down with the bad." Patient may want to have someone help until they have regained most of the strength and mobility. Stair climbing is an excellent strengthening and endurance activity . Do not try to climb steps higher than the standard height (7 inches) and always use a handrail for balance . As you become stronger and more mobile, you can begin to climb stairs foot over foot. .

18. Advanced exercises and activities Once the patient have regained independence for short distances and a few steps, they may increase their activity . The pain of the knee problems before surgery and the pain and swelling after surgery have weakened the knee . A full recovery will take many months. The following exercises and activities will help the patient to full recovery.

19. Standing knee bends Standing erect with the aid of a walker or crutches. lift the thigh and bend knee as much as they can . Hold for 5 to 10 seconds . Then straighten the knee, touching the floor with the heel first. Repeat several times until fatigued.

20. Assisted knee bends Lying on the back, place a folded towel over the operated knee and drop the towel to the foot. Bend the knee and apply gentle pressure through the towel to increase the bend. Hold for 5 to 10 seconds; repeat several times until fatigued. .

21. Knee exercises with resistance patient can place light weights around the ankle and repeat any of the above exercises . These resistance exercises usually can begin four to six weeks after the surgery. Use one- to two-pound weights at first; gradually increase the weight as the strength returns.

22. exercycling Exercycling is an excellent activity to help the patient regain muscle strength and knee mobility . At first, adjust the seat height so that the bottom of your foot just touches the pedal with your knee almost straight . Peddle backward at first. .

23. exercycling Ride forward only after a comfortable cycling motion is possible backwards. As he patient become stronger (at about four to six weeks) slowly increase the tension on the exercycle . Exercycle for 10 to 15 minutes twice a day, gradually build up to 20 to 30 minutes, three or four times a week . .

24. exercycling Pain or Swelling after Exercise You may experience knee pain or swelling after exercise or activity. They can relieve this by elevating leg and applying ice wrapped in a towel. Exercise and activity should consistently improve the strength and mobility.

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